Provider Demographics
NPI:1033780416
Name:DIZON, NELL ANGELA F
Entity Type:Individual
Prefix:MS
First Name:NELL ANGELA
Middle Name:F
Last Name:DIZON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 RICHLAND PL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2332
Mailing Address - Country:US
Mailing Address - Phone:301-518-3665
Mailing Address - Fax:
Practice Address - Street 1:3814 12TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2630
Practice Address - Country:US
Practice Address - Phone:202-569-3526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician